Provider Demographics
NPI:1417934449
Name:COHEN, JASON D (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:D
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 SHREWSBURY AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3006
Mailing Address - Country:US
Mailing Address - Phone:732-530-4949
Mailing Address - Fax:732-212-1171
Practice Address - Street 1:776 SHREWSBURY AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-3006
Practice Address - Country:US
Practice Address - Phone:732-530-4949
Practice Address - Fax:732-530-3618
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64488207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ363657100OtherUS DEPT OF LABOR
NJP2103741OtherOXFORD
NJP00080799OtherRR MEDICARE
NJCC3884OtherRR MEDICARE GRP#
NJ8638306Medicaid
NJJ19273OtherHEALTHNET
NJ3222403Medicaid
NJ7399020OtherAETNA
NJ037894AYKMedicare ID - Type UnspecifiedMEDICARE
NJP00080799OtherRR MEDICARE
NJ3222403Medicaid